UAE residents' growing resistance to antibiotics... cause and effects

By

Majorie van Leijen

PublishedTuesday, August 21, 2012

Resistance to antibiotics is on the rise and a common symptom among patients in the UAE. Overuse is one of the reasons. You can better be safe than sorry, they say. Especially when it comes to people’s health, this wisdom is happily applied. Medicine are high in supply as well as demand in health world. But about the effectiveness not everybody agrees.

Antibiotics are one of the most commonly prescribed medications all around the world. When a patient suffers from fever, diarrhea, or even a running nose the antibiotics box pops open, and the illness is battled with this strong antidote.

But there are side effects. One of these side effects is that the patient can build up a resistance to antibiotics when taken too often.

Resistance to antibiotics is on the increase worldwide, and last year the Health Authority Abu Dhabi (HAAD) introduced the Antibiotics Resistance Surveillance (ARS), which would discover whether the problem lies with the doctor, the patient or the pharmacy.

Antibiotics are meant to fight bacteria, and viruses do not require such a treatment, according to Dr. Suresh Menon, medical director and specialist of internal medicine at Lifeline Hospital Jebel Ali. However, in case of a virus the drug is often prescribed and more patients are building up resistance to antibiotics, requiring a stronger antibiotic cure each time a bacterium is found.

Often, the blame lies with the patient himself, says Suresh. “Many patients come to the doctor requesting antibiotics. They think they know what they need and they insist; doctors may feel pressured by this,” says Suresh.

According to him prescribing antibiotics should not go without proper diagnosis. “When a patient comes in with symptoms like fever, a running nose, or a sore throat it is mostly caused by a virus. But the symptoms of a virus can be similar to that of a bacterium. A blood sample could determine what the case is.”

However, Dr. Suresh says he prefers to wait and see in such cases. “Unless the symptoms are worrying and there are reasons to think of a bacterium, such as a recent travel history, I would send the patient home rather than drawing quick conclusions.

Dr. Sunita believes it would be unfair to say that doctors have a tendency to overuse antibiotics. “There is a thin line between when antibiotics should be given and when not. A patient with fever may not be willing to wait before a bacterial infection is proven in him before starting an antibiotic.

“Some antibiotics are prescribed in a case of viral infection to prevent a secondary bacterial infection,” she adds. But according to Dr. Suresh this is where the problem lies. “Doctors sometimes just want to be safe, so they prescribe something that could help, without establishing what the situation is.”

Apart from doctors and patients favouring the antibiotics alike, the pressure of the pharmaceutical companies plays a role too. “Big pharmaceutical companies have marketing campaigns advertising the latest antibiotics,” says Suresh.

Added to that many pharmacies are reportedly selling antibiotics over the counter, disregarding the fact that this is illegal. “We are not allowed to sell antibiotics over the counter,” tells a pharmacist regulated by

Dubai Health Authority. “Yet many people come to ask about antibiotics. They say that they can get it at other pharmacies.”

“I keep a stack at home,” admits S. Kumar, an Indian resident of Dubai. “And I get them very easily over the counter. When I feel a soaring throat coming up, I just want to take a quick cure, without having to visit the doctor first.”

S. Kumar says that he knows when to take the antibiotics and how. But according to Suresh, this can be risky. “A patient may not always know what is right. And in many cases antibiotics are not even required, nor is a doctor’s visit.

“I think many people want to get back to work as soon as possible,” he says. “They may not have any family support here and they rely on their work. Social scenarios do play a role.”

According to Dr. Sunita a common cause for resistance towards antibiotics is the fact that many people do not finish the course of the prescribed antibiotic. “They stop when they start feeling good again without completing the course.”

Furthermore, resistance also occurs naturally as bacteria can mutate very fast. The Beta lactamase enzyme produced by certain organism can lead to resistance.”